A fleam is a surgeon’s lancet, drawn in a highly stylized manner; it’s found in the arms of the Worshipful Company of Barbers, 1451 [Bromley & Child 14]. The blade is to chief by default. The fleam is used as a symbol by the Society’s chirurgeons (and by some Kingdoms’ chirurgeon groups as well), but it is not considered a restricted charge in Society heraldry.
The Chirurgeonate bears: Gules, on a goutte argent a fleam gules.
Danyel Leech bears: Vert, three fleams Or.
Jeanne d’Aussay bears: Per chevron azure crusilly Or, and argent, in base a fleam gules.